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  • Karen Hayter DPT

Rotator Cuff Tears

What is the Rotator Cuff?

The shoulder joint is not a stable joint and relies heavily on the rotator cuff to help with stabilization. The rotator cuff is a group of 4 muscles and their tendons that surround the shoulder joint and provides external stabilization. Rotator cuff injuries are common and can occur due to accident, trauma, or repeated overuse of the shoulder. Risk of injury to the rotator cuff increases as a person ages and are more common later in life from normal age related changes.

Rotator Cuff Tears and Injuries

The rotator cuff can become inflamed or irritated due to heavy lifting, repetitive arm movements, or trauma such as a fall. A rotator cuff tear occurs when injury to the muscle or tendon causes tissue damage or disruption. There are two types of rotator cuff tears, “partial thickness” or “full thickness.” With partial thickness tears, only part of the tendon is torn, whereas with full thickness tears the whole tendon is torn. Tears often develop as a result of either, an acute traumatic event or with chronic over-use of the shoulder.

Signs of Rotator Cuff Tear or Injury

Rotator cuff tears can cause severe pain over the top of the shoulder or down the outside of the arm. It’s also likely one will notice shoulder weakness and decreased ability of use the arm due to pain or loss of motion. This can challenge one’s ability to perform their normal activities of daily living. Physical therapists help people address pain and stiffness, restore movement to the shoulder joint, and improve their tolerance to activities of daily living.

How Can Physical Therapy Help?

Once a rotator cuff tear has been diagnosed, the patient will work with an orthopedist and a physical therapist to determine if surgical intervention is needed or if nonsurgical management is more appropriate. Partial thickness tears are most commonly treated with conservative treatment like Physical Therapy. Full thickness tears can be managed conservatively as well, but they are commonly surgically repaired. Chronic rotator cuff tears are often not operable due to poor tendon health and atrophy of the rotator cuff muscle.

Non-Operative Treatment

Physical therapy can be an important management option for non-operable, chronic rotator cuff tears. Physical therapy will help restore shoulder range of motion, improve muscle strength, decrease pain, improve coordination to allow for return to your normal activities, and to help decrease the risk of re-injury in the future. Treatment plans are individualized based on the patient’s goals and what type of activities they want to return to.

Surgical Treatment

If surgical intervention is determined to be the most appropriate treatment, physical therapy can help you both, before and after the procedure. Physical therapy is an important part of your recovery from surgery and treatment includes normalizing range of motion, improving rotator cuff and other surrounding shoulder muscles strength, and improving overall function. Your surgeon will provide a post-op protocol and the physical therapist will help educate you on expected progressions and guide you through the protocol. Following surgery, your shoulder will be susceptible to re-injury and it’s important to follow the postoperative instructions provided by the surgeon and physical therapist.

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